What is atherosclerosis: symptoms and treatment
A Atherosclerosis is a chronic degenerative cardiovascular disease, which damages the arteries due to the accumulation of lipids (cholesterol and other fatty elements) in their walls, triggering an inflammatory process.
It is a disease with a high prevalence in the population and is largely related to less healthy behaviors and lifestyles in our daily lives.
A diet rich in fats and calories, little or no physical activity (sedentary lifestyle), smoking and salt consumption are some of the “ingredients” that contribute to the development of atherosclerosis.
The accumulation of lipids in the arteries leads to a loss of elasticity of the arteries. When atherosclerotic plaques develop, the arteries narrow.
The disease develops slowly, with plaque buildup lasting years or decades. At any time, an acute event can cause them to rupture, bringing substances contained in the atheromatous plaque into contact with the blood.
When this happens, this material triggers blood clotting. The consequence is the sudden and total obstruction of the blood vessel, interrupting the blood flow, resulting in a heart attack or stroke.
Sometimes blood clots break off and move through the bloodstream until they block an artery in other parts of the body. Similarly, pieces of atherosclerotic plaque can break off and eventually block an artery elsewhere.
Consequences of atherosclerosis
Atherosclerosis usually produces no symptoms until there is marked narrowing (more than 70%) or blockage of one or more arteries.
Symptoms therefore depend, on the one hand, on the location of the affected artery and, on the other hand, on whether the artery has been narrowed gradually or blocked suddenly.
When narrowing is progressive, the first symptom may be pain or cramping at times when blood flow is not sufficient to meet tissue oxygen requirements.
- During exercise, a person may feel pain or discomfort in the chest (angina) if the blood supply to the heart is insufficient. This pain disappears within a few minutes when the exercise is stopped.
- When walking, a person may experience cramping in the legs if there is not enough blood supply to the local muscles.
- If the arteries that supply blood to one or both kidneys narrow, kidney failure or dangerously high blood pressure may occur.
When artery blockage is sudden, the symptoms can be a heart attack if the arteries that supply the heart (coronary arteries) are suddenly blocked.
If the blockage occurs in the arteries that supply the brain, a stroke may result.
If it is the arteries in the legs that become blocked, the consequence can be ischemia (lack of blood supply) in a foot, toe or leg.
Risk factors for atherosclerosis can be divided into two categories: modifiable factors (which can be intervened) and nonmodifiable factors.
Modifiable factors include:
Of these, the most important risk factor is smoking, as it leads to a decrease in the level of the so-called “good cholesterol” (HDL) and an increase in the “bad cholesterol” (LDL).
On the other hand, it causes an increase in the amount of carbon monoxide in the blood, which can increase the risk of damage to the artery walls, further decreasing the amount of blood reaching the tissues.
In addition, smoking increases the tendency for blood to clot.
However, people who stop smoking immediately reduce their risk of atherosclerosis to half that of people who continue to smoke, regardless of how long they smoked before stopping.
Non-modifiable risk factors include.
- Family history of early atherosclerosis (a close male relative who developed the disease before age 55, or a female relative who developed the disease before age 65).
- Advanced age.
- Male gender.
The diagnosis of atherosclerosis is based on the evaluation of symptoms and laboratory and imaging tests.
Blood tests are used to look for risk factors for the disease, while imaging tests are used to detect the presence of atherosclerotic plaques.
Individuals with symptoms suggestive of a blocked artery should undergo a thorough medical examination to determine the location and extent of any blockage.
For people who do not have symptoms but have risk factors, doctors usually order blood tests to measure glucose, cholesterol, and triglyceride levels.
The tests vary depending on the organ involved. For example, if the heart is suspected, it is usual to perform an electrocardiogram, blood tests to check for substances that indicate cardiac damage (markers of myocardial necrosis).
In some cases, a stress test or cardiac catheterization may be requested.
The treatment of atherosclerosis is a life’s work. There is not exactly a cure, because it is not possible to dissolve the fatty plaques once they have formed.
Prevention is therefore the most effective course of action, by controlling or eliminating the risk factors.
In some cases, it is possible to use vasodilator drugs, for example, which limit the impact of atherosclerotic plaques.
When atherosclerosis becomes severe enough to cause complications, these complications must be treated. These include the following:
- Angina (temporary chest pain or feeling of pressure in the chest);
- Heart attack;
- Cardiac arrhythmias;
- Heart failure;
- Chronic kidney disease;
- Claudication on walking (pain in twitching after walking a few yards);
- Ulcers in the lower limbs.
Prevention of atherosclerosis is extremely important, as it is a major cause of many of the most serious and life-threatening diseases in modern society.
With the exception of age, sex, and genetic predisposition, all other risk factors can be eliminated.
Some prevention tips:
- Quit Smoking;
- Control hypertension, diabetes, and dyslipidemias;
- Healthy diet (avoiding salt, sugar and excess fat);
- Regular and moderate physical exercise;
- Avoid stress.